Published online December 1, 2008
PEDIATRICS Vol. 122 No. 6 December 2008, pp. e1123-e1127 (doi:10.1542/10.1542/peds.2008-0770)
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ARTICLE

Hearing Loss in Children With Congenital Cytomegalovirus Infection in Relation to the Maternal Trimester in Which the Maternal Primary Infection Occurred

Ina Foulon, MDa, Anne Naessens, MD, PhDb, Walter Foulon, MD, PhDc, Ann Casteels, MDd and Frans Gordts, MD, PhDa

Departments of a Otolaryngology-Head and Neck Surgery
b Microbiology
c Obstetrics
d Neonatology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium

OBJECTIVES. The purpose of this work was to study the relation between maternal trimester of primary infection with cytomegalovirus and the occurrence of sensorineural hearing loss in the congenitally infected offspring.

PATIENTS AND METHODS. Thirty-four consecutive live-born children diagnosed with a congenital cytomegalovirus infection after maternal primary cytomegalovirus infections were included in the study. Five were lost for follow-up, and 1 died. Of the remaining 28 congenitally infected children, an estimation of the maternal trimester in which cytomegalovirus primary infection occurred was performed. All of the children were investigated for potential sensorineural hearing loss.

RESULTS. Five of the maternal infections occurred in the first trimester, 12 in the second trimester, and 11 in the third trimester of pregnancy. Sensorineural hearing loss was detected in 4 (80%) of the 5 congenitally infected children who were infected after a primary maternal infection in the first trimester of pregnancy and in 1 (8%) of the 12 children when the maternal infection occurred in the second trimester of pregnancy. No sensorineural hearing loss was detected after primary maternal infection occurring in the third trimester. Fluctuation and improvement of sensorineural hearing loss were seen regardless the trimester of pregnancy during which maternal primary infection occurred. Progression of sensorineural hearing loss occurred in 2 children born after a maternal primary infection of the first trimester.

CONCLUSIONS. Hearing loss seemed more common in infants with congenital cytomegalovirus infection who were born to women who experienced a primary cytomegalovirus infection in the first trimester of pregnancy than when infection took place later in pregnancy.

Key Words: neonatal hearing screening • cytomegalovirus • congenital infection • maternal primary infection • maternal trimester

Abbreviations: CMV—cytomegalovirus • cCMV—congenital cytomegalovirus • Ig—immunoglobulin • SNHL—sensorineural hearing loss • ABR—auditory brainstem response • DPOAE—distortion products otoacoustic emission

Accepted Sep 4, 2008.


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